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PSA went up to 15.6. Have been on Zytiga/Dexa since August, went froom 36 to 5, held here for 6-7 months. Any suggestions on what might be next from you great set of folks. I see my MO this week and referral at Ohio State, hopefully within a couple weeks. I suspect bone scans, etc will be coming. Thanks.
Pluvicto.
prostatecancer.news/2020/05...
You may wish to do Provenge at around the same time because the two may be synergistic.
I would have said Xofigo, except that they won't give you Pluvicto after Xofigo, but they will let you have Xofigo after Pluvicto. It doesn't make sense, but that's just the way it is.
After Xofigo some of your bones can be cracked especially if you where not treated with bone strengthening medication and if you are unlucky. That is (i believe) why they don't want to schedule Pluvicto afte Xofigo (you may miss the appointments for Pluvicto) plus Xofigo is not a systemic treatment therefore they give less priority to that as it can reduce your blood count and prevent you from doing Pluvicto. This is my strictly personal opinion and I am not a doctor. Therefore first Pluvicto and than Xofigo if you qualify. (Your bone marrow function and blood counts sufficient). I may be totally wrong, but makes sense to me.
What you're referring to is that the combination of Xofigo and Zytiga or Xtandi has to be prescribed with Xgeva or Zometa to prevent fractures. The reason that they can't prescribe Pluvicto after Xofigo has nothing to do with that. It is simply because the FDA approval of Pluvicto was based on the VISION trial. In that trial, they excluded men who'd already had Xofigo. They did that only because Pluvicto might have a lesser effect after Xofigo, and they wanted to give Pluvicto the best chance of succeeding.
Xofigo is a systemic treatment. It treats bone metastases everywhere in the body.
I understand that logic of the FDA. I was very much into Xofigo when I was diagnosed with so many bone mets what I have. My understanding is that Xofigo is prescribed when someone develop a bone pain. I asked my oncologist about it and both my former and my current oncologists had a same opinion that Xofigo is not helping with the cancer but only with the bones. I personally would avoid Xofigo as much as I can. It doesn't help you with your cancer as a whole. I would rather have Provenge now as I don't have a bone pain.
That's true that both bone pain and no visceral metastases are required for Xofigo. That's just how it was tested and FDA approved. I suspect a benefit even before bone pain is felt, but such are the vagaries of FDA approval.
Xofigo treats bone metastases in every bone. If you have the type of PCa that is only invading bone for now, it does indeed "help with the cancer." It doesn't cure the cancer, nothing does, but it certainly helps.
Similarly, Pluvicto only treats cancer cells that express PSMA. If you have the type of PCa that is largely expressing PSMA for now, it does indeed "help with the cancer." It doesn't cure the cancer, nothing does, but it certainly helps.
I'm hopeful about Th-227, which combines the best features of each:
Thanks for your contribution. I understand all of this. I have to say that I have much less enthusiasm now to jump into either Pluvicto or Xofigo than I had immediately after my diagnosis. However, it can change if I develop bone pain. With bone pain I wouldn't care about the cancer as a systemic disease. I would only care that the pain goes away. I know myself as I had very intense sciatica nerve pain before starting Degarelix and jumping into an early 6 cycles chemotherapy. I can't recall anymore my side effects from the chemo. My blood count is in a normal range.
Just trying to process options. Since taxotere, eligard and zytiga failed, I don't think degaralex would be prudent. I'm curious about Provence and pluvicto. Would they run concurrently, is there research on this? Also where do I find list of places that offer each and/or both? I'm in Ohio
Where are you located? City/State.............Thank you and keep posting....
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 06/20/2022 7:17 PM DST
Urbana ohio
Thank you sir..... seems like a nice town.....Stay well...
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 06/20/2022 9:48 PM DST
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